Gastro hep advances最新文献

{"title":"EUS Guided Enterocolostomy for the Palliation of Malignant Small Bowel Obstruction From a Cecal Adenocarcinoma","authors":"Brandon Rodgers,&nbsp;Abraham Mathew,&nbsp;Hadie Razjouyan","doi":"10.1016/j.gastha.2024.10.016","DOIUrl":"10.1016/j.gastha.2024.10.016","url":null,"abstract":"<div><div>Malignant bowel obstruction is a challenging complication in advanced gastrointestinal malignancies with varying treatment strategies including medical, surgical and endoscopic therapies, each with their own limitations. Endoscopic ultrasound–guided enterocolostomy has been previously reported as an option for patients who are not surgical candidates or ideal candidates for enteral stenting. In this case, endoscopic ultrasound–guided enterocolostomy is used for the palliation in a patient with a completely obstructing large cecal adenocarcinoma who declined surgical intervention.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100576"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Burden of Patients With Chronic Idiopathic Constipation in the USA Before and After Prucalopride Initiation","authors":"Paul Feuerstadt ,&nbsp;Mei Lu ,&nbsp;Emi Terasawa ,&nbsp;Brian Terreri ,&nbsp;Shawn Du ,&nbsp;Selina Pi ,&nbsp;Ben Westermeyer ,&nbsp;Rajeev Ayyagari ,&nbsp;Anthony Lembo ,&nbsp;Baharak Moshiree ,&nbsp;Mena Boules ,&nbsp;Brooks D. Cash","doi":"10.1016/j.gastha.2025.100664","DOIUrl":"10.1016/j.gastha.2025.100664","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Chronic idiopathic constipation (CIC) is associated with substantial health care resource utilization (HCRU) and economic burden; however, real-world evidence on the impact of treatment initiation on HCRU and health care costs are limited. We evaluated HCRU and direct health care costs associated with prucalopride initiation in patients with CIC in the United States.</div></div><div><h3>Methods</h3><div>Data were collected between January 1, 2015, and June 30, 2020, from the IBM MarketScan Commercial Claims and Encounters and Medicare Supplemental Databases for 690 adults with ≥ 1 prescription fill for prucalopride and ≥ 1 constipation-related diagnosis code. All-cause and constipation-related HCRU (outpatient, emergency room, and inpatient visits) for all patients, and pharmacy and medical health care costs for those aged 18–64 years were assessed 6 months before (baseline) and after (study period) prucalopride initiation. Subpopulations examined were patients with prior CIC medication use and males with CIC.</div></div><div><h3>Results</h3><div>Compared with baseline, the mean number of any constipation-related outpatient visits (2.26 vs 1.52; <em>P</em> &lt; .001) and the proportions of patients with these visits (82.6% vs 58.8%; <em>P</em> &lt; .001) significantly decreased after prucalopride initiation. In 564 patients, total constipation-related health care costs significantly increased from baseline during the study period (mean: $1497 vs $2332; <em>P</em> &lt; .001), primarily driven by increased pharmacy costs after prucalopride initiation ($621 vs $1751; <em>P</em> &lt; .001). Constipation-related medical costs significantly decreased during the study period ($876 vs $580; <em>P</em> &lt; .001). Some constipation-related HCRU and health care costs decreased after prucalopride initiation in patients with prior CIC medication use and males.</div></div><div><h3>Conclusion</h3><div>In adults with CIC, constipation-related HCRU and medical costs decreased, while constipation-related health care costs and pharmacy costs increased 6 months after prucalopride initiation.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 7","pages":"Article 100664"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessments of Health Utilities in Patients With Metabolic Dysfunction-Associated Steatohepatitis: Cross-Walk Between Disease-Specific Chronic Liver Disease Questionnaire, Short Form SF-6D, and EuroQol EQ-5D Instruments","authors":"Zobair M. Younossi ,&nbsp;Maria Stepanova ,&nbsp;Yestle Kim ,&nbsp;Stephen Dodge ,&nbsp;Dominic Labriola ,&nbsp;Rebecca Taub ,&nbsp;Fatema Nader","doi":"10.1016/j.gastha.2025.100642","DOIUrl":"10.1016/j.gastha.2025.100642","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The EuroQol-5D (EQ-5D) is a commonly used measure of health utilities to calculate quality-adjusted life years. For the clinical trials that use Chronic Liver Disease Questionnaire-nonalcoholic fatty liver disease (CLDQ-NAFLD) or Short Form-36 (SF-36), ability to convert the health-related quality of life scores (CLDQ-NAFLD or SF-36) to EQ-5D scores provides a valuable method to estimate health utility.</div></div><div><h3>Methods</h3><div>Baseline data of noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) patients were used in this study. We used 2 cross-walk algorithms to estimate EQ-5D scores. The first algorithm used 6 domains of CLDQ-NAFLD in a fractional logistic model to yield EQ-5D estimates. The other algorithm included calculation of SF-6D utility scores from SF-36 items, which were fed into a regression model that estimated EQ-5D scores from SF-6D scores.</div></div><div><h3>Results</h3><div>There were 883 MASH patients with CLDQ-NAFLD and SF-36 data: 25% ≥65 years, 44% male, 80% obese (body mass index &gt;30), 67% type 2 diabetes, 62% F3 fibrosis, and 38% F1B/F2 fibrosis. The mean estimated EQ-5D scores were 0.851 (standard deviation = 0.146) according to CLDQ-NAFLD-based algorithm and 0.853 (standard deviation = 0.097) according to the SF-36-based algorithm. The correlations between the 2 estimated EQ-5D scores were up to +0.74. Similar to the total sample, the differences between the mean EQ-5D estimates using either calculation method did not exceed 0.012 in all studied subgroups (by age, sex, obesity, type 2 diabetes, and fibrosis stage).</div></div><div><h3>Conclusion</h3><div>Both cross-walk algorithms for the calculation of the EQ-5D utility scores in MASH patients were estimable with CLDQ-NAFLD or SF-36 instruments. A high positive correlation was seen between the total score and subgroup estimates using either method.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 6","pages":"Article 100642"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insurance Denial of Biologic Therapy is Associated With Reduced Remission Rates in Inflammatory Bowel Disease Patients","authors":"Erin Zisman ,&nbsp;Madeline Alizadeh ,&nbsp;Leah Rossmann ,&nbsp;Jennifer Grossman ,&nbsp;Cydney Nguyen ,&nbsp;Pinkle Paul ,&nbsp;Uni Wong","doi":"10.1016/j.gastha.2025.100647","DOIUrl":"10.1016/j.gastha.2025.100647","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Biologic therapy is indicated for patients with moderate to severe inflammatory bowel disease (IBD) and delays in access to these medications have been associated with higher health-care utilization. We examined whether patients who experienced insurance denials of biologics had worse outcomes, as indicated by disease activity and the number of emergency department (ED) visits and hospitalizations had following medication denial.</div></div><div><h3>Methods</h3><div>Our single-center retrospective cohort study included 169 patients with IBD who were seen at a tertiary care center (University of Maryland Medical Center) and had an insurance denial for biologic therapy between March 2021 and October 2021. Data were collected through chart review.</div></div><div><h3>Results</h3><div>At 6 months following denial, 58.0% of patients were in remission, 37.9% had active disease, and 4.1% had unknown status. Those who did not receive medication approval were significantly more likely to have active disease (Odds ratio = 0.16, 95% confidence interval = [0.04‒0.69] <em>P</em> = .042). Compared to patients in remission after delay in therapy initiation, those with active disease were likelier to receive steroids in the year following denial (38.5%, <em>P</em> &lt; .001), trended toward higher likelihood of ED visits (<em>P</em> = .062), and had higher likelihood of hospitalization in that time (27.7% vs 8.2%, <em>P</em> = .002), with a higher number of average ED visits (<em>P</em> = .019) and hospitalizations (<em>P</em> = .003). Patients with active disease post denial had a nearly 80% increase in days between denial and final approval (<em>P</em> = .031).</div></div><div><h3>Conclusion</h3><div>Our study demonstrates an association between insurance denial of biologic therapy and lack of clinical remission with associated increased health-care utilization in IBD patients.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 6","pages":"Article 100647"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Type 2 Autoimmune Pancreatitis Suggesting Two Potential Disease Activity Markers","authors":"Kazuki Natsui ,&nbsp;Seiichi Yoshikawa ,&nbsp;Ayano Kagata ,&nbsp;Yusuke Horibata ,&nbsp;Hiroyuki Usuda ,&nbsp;Manabu Takeuchi ,&nbsp;Shuji Terai","doi":"10.1016/j.gastha.2025.100635","DOIUrl":"10.1016/j.gastha.2025.100635","url":null,"abstract":"<div><div>Autoimmune pancreatitis (AIP) is divided into 2 main subtypes: type 1 AIP (AIP-1) and type 2 AIP (AIP-2). This report describes a young woman diagnosed with AIP-2 using endoscopic ultrasound–guided tissue acquisition. AIP-2 has been reported less frequently than AIP-1 as serologic abnormalities and other organ involvement except for inflammatory bowel disease are absent. Additional laboratory analyses suggest that serum interleukin-8 and leucine-rich alpha-2 glycoprotein are more efficient disease activity biomarkers than conventional C-reactive proteins. We hope that this case report will contribute to the discovery of diagnostic biomarkers for AIP-2.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 6","pages":"Article 100635"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extramedullary Involvement of Myelofibrosis in the Colon: A Case Report","authors":"Krystal Mills ,&nbsp;Naseema Gangat ,&nbsp;Victor Chedid","doi":"10.1016/j.gastha.2024.11.003","DOIUrl":"10.1016/j.gastha.2024.11.003","url":null,"abstract":"<div><div>Colitis refers to a range of inflammatory conditions of the colon and each condition requires a distinct diagnostic and therapeutic approach. Common differentials include inflammatory bowel disease, ischemic colitis, and infections. Endoscopic evaluation is often a critical adjunct in determining the underlying cause of colitis and concomitant biopsies further improve diagnostic accuracy. Work up of this clinical case revealed the diagnosis of extramedullary hematopoiesis presenting as colonic ulcers in a patient with myelofibrosis, which has not yet been described in the existing literature.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100587"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Program Offering CT Colonography for Colorectal Cancer Screening Avoided Colonoscopy and Sedation Risks in Heart Transplant Candidates and Expedited Screening: A Retrospective Observational Study","authors":"Diane R.M. Somlo ,&nbsp;Reece J. Goiffon ,&nbsp;James M. Richter ,&nbsp;Asishana A. Osho ,&nbsp;Cordula Magee ,&nbsp;Sonali Palchaudhuri","doi":"10.1016/j.gastha.2024.10.014","DOIUrl":"10.1016/j.gastha.2024.10.014","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100574"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicaid and Medicare Utilization of Direct-Acting Antiviral Medications for Patients With Hepatitis C","authors":"Xiaohan Ying ,&nbsp;Alexander Zhao ,&nbsp;Nicole Ng ,&nbsp;Russell Rosenblatt ,&nbsp;Catherine Lucero ,&nbsp;Arun B. Jesudian","doi":"10.1016/j.gastha.2024.10.024","DOIUrl":"10.1016/j.gastha.2024.10.024","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100584"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric Acid Suppression Is Associated With Higher Rates of Colectomy in Patients With Inflammatory Bowel Disease","authors":"Aun R. Shah ,&nbsp;Nurlan Aliyev ,&nbsp;Zarak H. Khan ,&nbsp;Rubab Ali ,&nbsp;Mohammad Bilal","doi":"10.1016/j.gastha.2024.09.008","DOIUrl":"10.1016/j.gastha.2024.09.008","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100553"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activation of VEGFR3 and MLC2 are Critical for GLP-2 Enhancement of Chylomicron Transport","authors":"Lili Tian ,&nbsp;Majid Mufaqam Syed-Abdul ,&nbsp;Gary F. Lewis","doi":"10.1016/j.gastha.2024.100605","DOIUrl":"10.1016/j.gastha.2024.100605","url":null,"abstract":"<div><h3>Background and Aims</h3><div>A significant proportion of absorbed dietary triglycerides (TGs) remain in various intracellular and extracellular intestinal compartments for many hours after fat ingestion, including in the lymphatic circulation. TGs retained in the intestine or lymphatics can be mobilized by the gut peptide glucagon-like peptide 2 (GLP-2) and other stimuli. Our previous published data demonstrated that GLP-2 enhances lymph flow by acting distal to the enterocyte, specifically by enhancing lacteal contractility, in an enteric nervous system–dependent fashion. The objective of the present study was to further explore various intermediates in the signaling pathway whereby GLP-2 enhances mesenteric lymph flow. In this study we focused on the roles of vascular endothelial growth factor receptor 3 (VEGFR3) and myosin light chain 2 (MLC2), known to play important roles in lymphangiogenesis and lymphatic contractility, respectively.</div></div><div><h3>Methods</h3><div>A rat lymph fistula model was utilized in this study. An intraduodenal lipid bolus was applied to the rats 5 hours before the following intraperitoneal (i.p.) administrations: 1) saline (placebo), 2) GLP-2, 3) GLP-2 + MAZ-51 (a VEGFR3 inhibitor), 4) GLP-2 + SAR131675 (a second VEGFR3 inhibitor), 5) GLP-2 + ML-7 (a MLCK inhibitor). Lymph flow and TG output were assessed for 60 minutes after the i.p. administrations. In another set of animals, post-i.p. administration, tissue samples were collected to quantify VEGFR3 and MLC2 activation (via phosphorylation).</div></div><div><h3>Results</h3><div>We showed that GLP-2 treatment acutely activated VEGFR3 and MLC2, and that inhibition of VEGFR3 (via MAZ-51/SAR131675) and MLC2 (via ML-7) abolished GLP-2-induced lymph flow and TG output. Furthermore, VEGFR3 inhibition blocked MLC2 activation.</div></div><div><h3>Conclusion</h3><div>Our data suggest that the activation of VEGFR3 and MLC2 play critical roles in GLP-2’s enhancement of chylomicron secretion and that VEGFR3 activation is an important intermediary step in GLP-2’s activation of MLC2.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100605"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}